Clinical Chemistry I Week 13: Automation & POC

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Questions and Answers

What is one of the primary functions of LIS during the preanalytical phase?

  • Creating instrument worklists
  • Generating accession numbers for test orders (correct)
  • Transmitting quality control data
  • Validating patient treatment plans

In which phase does the LIS verify that test results fall within the reportable range?

  • Integration with HMIS
  • Analytic (correct)
  • Postanalytical
  • Preanalytical

What action does LIS take if a test result is a critical value?

  • Sends a summary report to billing
  • Automatically archives the result
  • Alerts laboratory staff to contact care unit emergently (correct)
  • Informs the patient directly

Which of the following is NOT a function of the LIS during the analytic phase?

<p>Creating lists of pending orders (C)</p> Signup and view all the answers

What is a special requirement that must be ensured throughout the laboratory information system usage?

<p>Data security and access control (A)</p> Signup and view all the answers

Which of the following is a key feature of automated analysis systems in clinical laboratories?

<p>Computerized signal processing (D)</p> Signup and view all the answers

What is a common method of mixing reactants in a chemical reaction phase?

<p>Vigorous lateral displacement (D)</p> Signup and view all the answers

Which type of analzer does NOT typically require an open system for operation?

<p>Nucleic acid analyzers (A)</p> Signup and view all the answers

Which of these components is crucial for maintaining optimal conditions during reactions in automated systems?

<p>Thermal regulation (B)</p> Signup and view all the answers

Which of the following tasks is a technician responsible for regarding laboratory equipment?

<p>Scheduled calibration and maintenance (C)</p> Signup and view all the answers

What defines point-of-care testing (POCT)?

<p>Testing activities located within the institution but outside clinical laboratories. (A)</p> Signup and view all the answers

Which setting is NOT typically considered a place for point-of-care testing?

<p>Nursing homes (B)</p> Signup and view all the answers

Who most often performs point-of-care testing?

<p>Non-laboratorians such as nurses and respiratory technicians (B)</p> Signup and view all the answers

Which statement about laboratory support for point-of-care testing is accurate?

<p>Laboratories must manage and train personnel for POCT programs. (D)</p> Signup and view all the answers

What is a primary benefit of using a Laboratory Information System (LIS)?

<p>Management of the information explosion in laboratories. (C)</p> Signup and view all the answers

Which of the following is a component of an Information Management System?

<p>People, processes, and data (A)</p> Signup and view all the answers

Which type of laboratories is NOT listed as a typical category of lab operations?

<p>Educational (A)</p> Signup and view all the answers

What is a key purpose of implementing systems approaches in laboratories?

<p>To tailor solutions based on specific lab needs. (B)</p> Signup and view all the answers

What is the primary benefit of automation in clinical laboratories?

<p>Reduced personnel requirements (D)</p> Signup and view all the answers

Which type of analysis allows for multiple tests to be conducted on a single specimen simultaneously?

<p>Parallel analysis (D)</p> Signup and view all the answers

What does 'carry-over' refer to in an analytical process?

<p>The accidental contamination of samples (C)</p> Signup and view all the answers

What is the purpose of centrifugation in the pre-analytical step of laboratory automation?

<p>To separate the sample into its components (B)</p> Signup and view all the answers

Which type of analyzer uses separate containers for each test and sample?

<p>Discrete analyzer (B)</p> Signup and view all the answers

What does 'throughput' refer to in the context of laboratory automation?

<p>The number of specimens processed over a time period (A)</p> Signup and view all the answers

In random-access analysis, how are specimens analyzed?

<p>Individually and independently of one another (B)</p> Signup and view all the answers

What characterizes batch analysis in clinical chemistry?

<p>Many specimens are processed together in the same session (D)</p> Signup and view all the answers

What is a key advantage of using discrete analyzers over continuous flow analyzers?

<p>Isolation of samples and reagents (D)</p> Signup and view all the answers

Which of the following best describes the concept of sample retrieval in automated laboratories?

<p>The process of accessing samples for testing (A)</p> Signup and view all the answers

Flashcards

Closed system

A system where samples and reagents are handled in a closed environment, reducing the risk of contamination and improving accuracy.

Open system

A system where samples and reagents are exposed to the open environment, increasing the risk of contamination.

Chemical Reaction Phase

The stage where chemical reactions occur within the analyzer. Factors like reaction vessels, mixing methods, and temperature control are crucial.

Total Laboratory Automation

These are the automated systems that perform tasks like specimen preparation, reagent handling, and analysis, increasing efficiency and accuracy in laboratories.

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Specimen Preparation and Processing

The initial steps of lab testing, involving procedures like specimen loading, aspiration, and reagent preparation.

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Automation in Clinical Chemistry

A process where an instrument performs many lab tests, needing minimal human intervention. It can be defined as a controlled operation of a system by mechanical or electronic devices without manual input.

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Automation in Modern Labs

The use of automated instruments and systems in modern clinical chemistry labs.

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Batch analysis

Performing many tests simultaneously on a group of samples, often at the same time.

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Random-access analysis

Running tests individually on each sample, allowing for flexibility in test selection.

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Sequential analysis

Performing a series of tests in a specific order, with each sample processed one after another, producing results in the same order.

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Carry-over

The transfer of a small amount of analyte or reagent from one sample to the next, potentially contaminating the next sample.

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Multiple-channel analysis

Performing multiple tests at a time on a single sample, producing results for all tests.

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Single-channel analysis

Performing a single test at a time on a sample, resulting in only one analyte's result.

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Parallel analysis

Running multiple processes simultaneously for each sample. It is similar to random access.

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Throughput

The number of samples an analyzer can process within a specific time frame.

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Point-of-Care Testing (POCT)

Analysis of patient samples performed outside the laboratory's physical facilities, often within the institution.

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Laboratory Information Systems (LIS)

A system used by laboratories to manage data and disseminate test results to relevant areas.

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Information Technology in Laboratories

The use of technology to manage the increasing volume of laboratory data, improve quality assurance, reduce errors, and accelerate the sample-to-result time.

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Systems Approach to Laboratory Information Management

The practice of considering the lab's specific needs, procedures, and outcomes when designing and implementing laboratory information management solutions.

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Information Management System

The set of computers, personnel, and procedures that make up a laboratory information management system.

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Types of Laboratories and LIS Needs

Analyzing the need for laboratory information management systems in different types of labs, such as research, analytical services, and manufacturing.

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Personnel Involved in POCT

POCT is often performed by personnel who are not lab specialists, such as physicians, nurses, or respiratory therapists.

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Laboratory Support for POCT

The laboratory is still responsible for the accuracy and interpretation of POCT results, even though it's performed elsewhere.

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Preanalytical Phase

The stage of laboratory testing that starts with patient information and ends with the release of a final result. This phase involves managing patient data, handling specimens, and generating orders.

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Analytical Phase

The stage of laboratory testing where the actual analysis of the specimen takes place. This involves running the test on the machine, analyzing the data, and verifying the results.

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Postanalytical Phase

The stage of laboratory testing that focuses on managing and delivering the final test results to the relevant healthcare providers. This includes reporting critical values, sending results to the clinical system, and billing for the tests.

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Data Privacy

A critical component of laboratory data privacy. This entails protecting user data, including patient demographics and test results, from unauthorized access and disclosure.

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Data Security

Ensuring only authorized personnel can access laboratory information systems and patient data. This involves using secure logins, controlled access levels, and appropriate security protocols.

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Study Notes

Clinical Chemistry I - 0202304

Week 13: Automation & POC

  • Topics covered: Automation in Clinical Chemistry, Why Automation?, Steps Automated in the Diagnostic Laboratory, Definitions (Batch analysis, Random-access analysis, Sequential analysis, Carry-over), Multiple-channel analysis, Single-channel analysis, Parallel analysis, Throughput, Types of Analyzers (Continuous Flow, Discrete), Continuous Flow Analyzer details, Discrete Analyzer details, Table 6-2: Summary of Chemistry Analyzer Operations, Total Laboratory Automation, Specimen Preparation, Chemical Reaction Phase, Measurement Approaches, Automation for the Clinical Laboratory, Areas of Automation, Technician Responsibility, Point of Care Testing (POCT), Place of Analysis, Personnel Issues, Classification of Types of Point-of-Care Testing Instruments or Devices (Table 17-1), Examples of POCT devices (Table 17-3), Troponin Measurement, Blood Gas measurement, HbA1C, Laboratory Support, Laboratory Information Systems (LIS), Information Technology (and why LIS is important), General Considerations for LIS, Types of Laboratories, Information Management System, LIS (digitalizing information), testing phases (Preanalytic, Analytic, Postanalytic), Special Requirements (Data Privacy, Data Security, Safety)

Automation in Clinical Chemistry

  • Automation is a process where an analytical instrument performs multiple tests with minimal analyst involvement.
  • Automation is defined as controlled operation of an apparatus or system by mechanical or electronic devices without human intervention.

Why Automation?

  • Increased laboratory capacity
  • Reduced errors
  • Faster turnaround time (TAT)
  • Optimized personnel utilization
  • Optimized space utilization

Steps Automated in the Diagnostic Laboratory

  • Pre-analytical steps: preparing orders, collecting samples, transporting to the lab, accessioning samples, centrifuging, decapping tubes, pre-sorting, transporting to the analyzer
  • Analytical steps: sample retrieval, sample storage, waste disposal, transmitting test results, and technical validation
  • Post-analytical steps: transmitting test results, technical validation

Definitions

  • Batch analysis: Grouping multiple specimens for analysis in the same session.
  • Random-access analysis: Performing analyses of multiple specimens sequentially, with each specimen analyzed for different tests.
  • Sequential analysis: Analyzing each specimen in a batch one after the other.
  • Carryover: Transfer of analyte or reagent from one specimen reaction to the next, contaminating the subsequent one.
  • Multiple-channel analysis: Multiple analytical processes performed concurrently on a single specimen.
  • Single-channel analysis: Single process (for results of a single analyte), similar to batch analysis.
  • Parallel analysis: Multiple processes at the same time.
  • Throughput: Number of specimens processed by an analyzer during a certain time.

Types of Analyzers

  • Continuous flow: Reagents and samples flow through tubing.
  • Discrete (Centrifugal): Separate cuvettes for each test and sample.

Continuous Flow Analyzer details

  • Samples aspirated into tubing, into a sample holder.
  • Reagents are added.
  • Chemical reaction in a flow-through cuvette.
  • Results measured by a spectro-photometer
  • Samples and air bubbles to create a flow through the cuvette

Discrete Analyzer details

  • Samples and reagents are in separate containers.
  • Multiple tests can be performed at once.
  • Minimizes carryover.
  • Disposable products are more expensive.

Additional Information

  • Troponin measurement: A method for measuring cardiac biomarkers.
  • Blood gas measurement: Optical sensors or optodes, better than electrochemical methods for calibrating and measuring.
  • HbA1c measurement: A method for measuring long-term blood glucose levels.

Laboratory Information Systems (LIS)

  • A method used to manage lab data and distribute results to respective areas.
  • Components of LIS include Hardware, Software, People, Procedures & Data.

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